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Vaccinations may soon open up

Under pressure from both private citizens and local health officials, state public health authorities might decide as soon as Wednesday to offer the H1N1 flu vaccine to all Nevadans.

"We've heard from public health officials and private physicians that it's time," said Ben Kieckhefer, a spokesman for the Nevada State Health Division. "If we do this, we want to make sure it's done orderly and properly."

Should the decision be made to open up the vaccination program to everyone, Kieckhefer said, the vaccine probably would be offered before next year.

He noted that administrators with the federal Centers for Disease Control and Prevention have not changed the agency's recommendations, which call for vaccinating "priority groups" while vaccine is still in short supply.

Five high-risk groups, according to the CDC, should be vaccinated first: pregnant women; household contacts and caregivers for children younger than 6 months; health care and emergency personnel who deal with patients; those between 6 months and 24 years of age; and people 25 to 64 with chronic health conditions.

But the CDC gives states the right to deviate from those guidelines if public health officials deem it appropriate.

On Wednesday, Kieckhefer said, Dr. Tracey Green, the Nevada state health officer, will meet with public health officials from throughout the state to see if every attempt has been made to "saturate" the priority groups with vaccine.

"If that has been done," he said, "there is no point sitting on the vaccine when there are plenty of others willing to come in and get it."

People over 65, particularly those with underlying health conditions, have been outspoken in their desire to get vaccinated, according to public health officials.

A recent analysis published in the Journal of the American Medical Association looked at more than 1,000 California patients hospitalized with H1N1 flu. It found that infants were most likely to be admitted for treatment, and patients 50 and older were most likely to die once admitted. The death rate was up to 20 percent for patients 50 and older, compared with about 2 percent in hospitalized patients under age 18.

Kieckhefer said the state ordered and shipped 477,400 doses of vaccine to public and private providers throughout Nevada to be used on the CDC's priority groups.

He said the tracking system is "weeks behind" in determining how many people have been vaccinated.

"Right now our charts are saying that 155,000 doses have been administered, and we know that's not right," he said. The state, he said, is depending on the self-reporting of providers to track vaccinations.

Since last week, Southern Nevada Health District officials have wanted to begin offering the vaccine to everyone. To ensure that happens, a frustrated health district official suggested that "elderly people who can't get a shot" call the state health division and demand action.

Past shortages of the H1N1 vaccine led to criticism of the district's distribution program by state administrator Richard Whitley in early November. Kieckhefer downplayed the apparent friction.

"We've tried to work with all the public health authorities," he said. "We're trying to get the vaccine out to as many people as quickly as possible. It's a common goal."

A state official had accused the district of unfairly limiting access to the vaccine. In e-mails that became public, Whitley demanded that Dr. Lawrence Sands, the district's chief health officer, give all five swine flu high-risk groups equal access to the vaccine. That's the practice in the rest of the state. It's also recommended by the federal Centers for Disease Control and Prevention.

The H1N1 vaccine was not given in Southern Nevada to adults 25 to 64 with underlying health conditions because Sands decided that, in light of the vaccine shortage, the other high-risk groups needed it more.

The health district, at Whitley's insistence, began vaccinating adults with underlying health conditions on Nov. 13.

Today, an H1N1 shot clinic will be held for Basic High School students in Henderson from 7 a.m. to noon.

It is sponsored by Clinics in Schools in partnership with several groups, including the Clark County School District and the Nevada State Health Division.

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